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<title>Retreat Registration</title>

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<body id="public" z>
	<div id="container" class="ltr">

		<h1 id="logo"></h1>

		<form id="form69" name="form69" class="wufoo topLabel page"
			autocomplete="off" enctype="multipart/form-data" method="post"
			novalidate action="user.jsp">

			<header id="header" class="info">
				<h2>Edit User Information</h2>

			</header>

			<ul style="text-align:left;">
				<li id="foli9"><label class="desc" id="title9" for="Field9">
						Email <span id="req_9" class="req">*</span>
				</label>
					<div>
						<input id="Field9" name="Field9" type="email" spellcheck="false"
							class="field text medium" value="redbanana.blueapple@gmail.com"
							maxlength="255" tabindex="12" required />
					</div></li>





				<li id="foli9"><label class="desc" id="title9" for="Field9">
						Password <span id="req_9" class="req">*</span>
				</label>
					<div>
						<input id="Field9" name="Field9" type="password"
							spellcheck="false" class="field text medium" value=""
							maxlength="255" tabindex="12" required />
					</div></li>
				<li id="foli9"><label class="desc" id="title9" for="Field9">
						Retype-Password <span id="req_9" class="req">*</span>
				</label>
					<div>
						<input id="Field9" name="Field9" type="password"
							spellcheck="false" class="field text medium" value=""
							maxlength="255" tabindex="12" required />
					</div></li>


				<li id="foli20" class="notranslate       "><label class="desc"
					id="title20" for="Field20"> Photo <br />Note: File upload
						fields are currently disabled due to server maintenance.
				</label>
					<div>
						<input id="Field20" name="Field20" type="file" class="field file"
							disabled="disabled" size="12" tabindex="5" />
					</div></li>


				<li id="foli0" class="notranslate      "><label class="desc"
					id="title0" for="Field0"> Name </label> <span> <input
						id="Field0" name="Field0" type="text" class="field text fn"
						value="Hoejin" size="8" tabindex="1" /> <label for="Field0">First</label>
				</span> <span> <input id="Field1" name="Field1" type="text"
						class="field text ln" value="Kwen" size="14" tabindex="2" /> <label
						for="Field1">Last</label>
				</span></li>


				<li id="foli2" class="complex notranslate      "><label
					class="desc" id="title2" for="Field2"> Address <span
						id="req_2" class="req">*</span>
				</label>
					<div>
						<span class="full addr1"> <input id="Field2" name="Field2"
							type="text" class="field text addr" value="14, Marion Avenue"
							tabindex="3" required /> <label for="Field2">Street
								Address</label>
						</span> <span class="full addr2"> <input id="Field3" name="Field3"
							type="text" class="field text addr" value="" tabindex="4" /> <label
							for="Field3">Address Line 2</label>
						</span> <span class="left city"> <input id="Field4" name="Field4"
							type="text" class="field text addr" value="Stony Brook"
							tabindex="5" required /> <label for="Field4">City</label>
						</span> <span class="right state"> <input id="Field5"
							name="Field5" type="text" class="field text addr" value="NewYork"
							tabindex="6" required /> <label for="Field5">State /
								Province / Region</label>
						</span> <span class="left zip"> <input id="Field6" name="Field6"
							type="text" class="field text addr" value="11790" maxlength="15"
							tabindex="7" required /> <label for="Field6">Postal /
								Zip Code</label>
					</div></li>
				<li id="foli8" class="phone notranslate leftHalf     "><label
					class="desc" id="title8" for="Field8"> Phone </label> <span>
						<input id="Field8" name="Field8" type="tel" class="field text"
						value="631" size="3" maxlength="3" tabindex="9" /> <label
						for="Field8">###</label>
				</span> <span class="symbol">-</span> <span> <input id="Field8-1"
						name="Field8-1" type="tel" class="field text" value="875" size="3"
						maxlength="3" tabindex="10" /> <label for="Field8-1">###</label>
				</span> <span class="symbol">-</span> <span> <input id="Field8-2"
						name="Field8-2" type="tel" class="field text" value="0563" size="4"
						maxlength="4" tabindex="11" /> <label for="Field8-2">####</label>
				</span></li>




				<li id="foli11" class="notranslate      "><label class="desc"
					id="title11" for="Field11"> Comments </label>

					<div>
						<textarea id="Field11" name="Field11"
							class="field textarea medium" spellcheck="true" rows="10"
							cols="50" tabindex="20" onkeyup="" value="" title="asdf" >I am so handsome.</textarea>

					</div></li>

				<li class="buttons ">

					<div>

						<input id="saveForm" name="saveForm" class="btTxt submit"
							type="submit" value="Submit" />
					</div>

				</li>


			</ul>
		</form>

	</div>
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